On the reliability and validity of central fatigue determination.

Physical performance fatigue can be ascribed to both peripheral and central components. Central fatigue, however, is an elusive entity, consisting of cognitive/sensory component and presumably also a neuro-physiological component that are difficult to tease apart and assess independently of each other. The most widely accepted method for the assessment of central fatigue is based on the premise that decreasing volitional muscle activation (VA), as determined by the interpolated twitch technique (ITT) in fatiguing muscles, reflects increasing central fatigue. Suffering its own shortcomings, the validity of VA determination under fatigued conditions has never been proven and is only assumed. This review presents evidence that questions ITT's reliability and validity in reflecting VA in the fatiguing muscle and, consequently, VA's validity for central fatigue assessment. Specifically highlighted is the paradox of children and endurance athletes, who share striking endurance characteristics, being claimed as more centrally fatigable than untrained adults. Further research and new directions are needed for confirming and quantifying central fatigue and teasing apart its psychologic and neuromotor components.